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RespiratoryClinicalYale Pediatric Respiratory Medicine faculty sees patients at several locations for a variety of respiratory problems including asthma, cystic fibrosis, chronic lung disease in both infants and older children, sleep related disordered breathing, and technology dependent patients, among other conditions:
Yale Asthma Care Center and the Pediatric Asthma Care TeamAsthma is the most common chronic respiratory illness in children. It affects 5-10% of all children in the United States, and accounts for the majority of missed school days. It is estimated that approximately one third of emergency department visits are related to asthma and that it is the most common reason for hospital admissions in children. Statistics show that the prevalence of asthma has been on the rise over the past 15-20 years, and that this trend continues. Although asthma cannot be cured and may be a life-threatening illness, it can be very well controlled with proper medication and education. The goals of asthma therapy are to have children lead normal, active lives, and prevent the occurrence of frequent troublesome symptoms or the need for emergency visits and hospitalization. To achieve these goals here at Yale, all groups who have participated in the care of any aspect of the child's asthma work together as a team. This team, the Pediatric Asthma Care Team (PACT) includes pediatricians and pediatric pulmonologists, allergists, emergency room physicians, intensivists, and nurse practitioners. This approach ensures that the lines of communication remain open between these various health care professionals, so that any changes in the child's asthma care plan are known to all, thus avoiding redundancy or deficiencies in therapy and confusion on the part of the patient and family and referring pediatrician. The PACT and Pediatric Asthma Program are directed by Alia Bazzy-Asaad, M.D.  The Cystic Fibrosis Care Center and ClinicOne of only two in the state of Connecticut, the CF Center in the Children's Hospital at the Yale-New Haven Hospital offers a multidisciplinary team approach to provide the most comprehensive, “state of the art” care of CF patients. Our experienced CF-care group includes 4 (board-certified) pediatric pulmonologists, 3 pediatric pulmonary fellows, a nurse practitioner, a social worker, a respiratory therapist, and a nutritionist. All of our team members meet together weekly in the Pediatric Specialty Clinic for regularly scheduled follow-up and care. Urgent visits are scheduled as needed. In addition, we have active collaborations with the pediatric gastroenterologists (GI), pediatric endocrinologists, and pediatric surgeons at the Children's Hospital. Approximately 130 patients with cystic fibrosis are followed at our Center, ranging in age from newborns to over age 65 years. The neonatal screening program for CF has been responsible for early identification of 2-4 infants with CF per year. While not State mandated, several hospitals in Fairfield and New Haven Counties participate in our program. Our collaboration with the Section of Pulmonary and Critical Care Medicine in the Department of Internal Medicine, in addition to the Medicine-Pediatrics program, has allowed the expansion of our Program for Adults with Cystic Fibrosis. Patients are transitioned to the adult program starting anywhere between ages 18 and 21 years, depending on the readiness of the patient. The Transition clinic meets twice a month in the Pediatric Specialty clinic in conjunction with our regularly scheduled CF clinic. We believe this arrangement allows us to serve the needs of both our pediatric and adult patients yet provide exquisite continuity with the most experienced CF-care givers. Educational workshops based on patients' needs and requests are offered periodically. Because many of our patients have very busy, hectic lives; we also publish a yearly CF Center Newsletter. The aim of the newsletter is to keep our patients and their families up to date on new therapies, nutrition issues, insurance issues, and our research program. Newsletters are mailed to homes and are available on this site (see link to CF Center Newsletter). The Cystic Fibrosis Center is directed by Marie
E. Egan, M.D..
The Yale Pediatric Sleep CenterThe Yale Pediatric Sleep Center, established in 1989, is dedicated to the evaluation of cardiorespiratory and sleep disorders in infants, children and adolescents. It is the longest standing sleep center that is solely dedicated to serving children in the State of Connecticut. The center is equipped with a new state-of-the-art comprehensive polysomnographic monitoring system that is staffed by pediatric sleep technologists. In addition to providing a clinical service, the Pediatric Sleep Center is committed to research and advancing scientific knowledge in this ever-growing discipline of pediatric sleep disorders. Infants, toddlers, children and adolescents with sleep problems can also be referred for evaluation in the Yale Pediatric Sleep Clinic, which is held twice a month. Evaluation for a suspected sleep related breathing problem begins with an initial consultation with a member of the Section of Pediatric Respiratory Medicine who will determine the most appropriate method of sleep assessment. Examples of referrals include those for:
Based on the consultation, a study is then scheduled. Direct referrals from healthcare providers to the Sleep Center are also accepted and can be made by calling the Center at (203) 688-1240 and requesting a direct referral form. On the night of the study the child is introduced to the sleep lab, which is located in the Yale Center for Clinical Investigation at Yale-New Haven Hospital. Our friendly and experienced staff will engage and prepare the child for the application of the monitoring equipment. A bed for one parent in the child's room is available. Sleep studies are scored according to current polysomnography standards and the sleep center medical director and faculty provide an interpretation from which a formal report is generated and sent to the referring physician in a timely fashion. The report includes recommendations for further management. The Yale Pediatric Sleep Center is directed by Alia
Bazzy-Asaad, M.D. and Sumit Bhargave, M.D. and is located at Yale-New Haven Children's Hospital (Map
and Directions). The Pediatric Respiratory Care UnitThe Pediatric Respiratory Care Unit (PRCU) is a unit that is specifically designed to accommodate the special medical and psychosocial needs of children with chronic respiratory failure, many of whom require mechanical support and are technology dependent. These are children who usually have a longstanding disorder that interferes with normal breathing such as:
The PRCU is a six-bed intermediate care unit that is staffed by a team that includes the pediatric respiratory physicians, nurses, respiratory therapists, occupational and physical therapists, a care coordinator, social worker, nutritionist and communication specialist. The PRCU provides an environment in which the medical, nutritional and psychosocial needs of these children are met by applying a multidisciplinary team approach. This affords the opportunity, time and space for the families of these children to learn and become directly involved with the care of their technology dependent child. The goal is to discharge the child to home once medically ready, with the parents and family educated and competent in their child's care which often involves tracheostomy and gastrostomy tube care. The education is provided by the multidisciplinary team that works intensively with the family during their child's stay in the unit. The PRCU is directed by Alia Bazzy-Asaad, M.D. BronchoscopyExamination of the upper and lower airway by flexible bronchoscopy and bronchoalveolar lavage is an important diagnostic tool in the evaluation of:
In many cases flexible bronchoscopy, which can be safely and comfortably performed under conscious sedation, eliminates the need for an exam under general anesthesia. Bronchoscopy is the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body. Bronchoscopies are performed in the pediatric operating room, and in the Pediatric Intensive Care Unit. The Pulmonologists in the section who perform this procedure have extensive experience with flexible bronchcoscopy including in the neonatal population. Pediatric Pulmonary Function TestingOver 1800 pulmonary function tests are performed each year to evaluate and follow lung disease in children. A full spectrum of Pulmonary Function Tests, including diffusion analysis and challenge tests, including exercise, are available. Working in a multi-disciplinary fashion this lab has participated in on-going studies on the long term sequelae of neonatal lung disease, the impact of new therapies on lung function in Cystic Fibrosis and the long term safety questions of inhaled insulin. Future courses of investigation include monitoring and assessment of airway inflammation in patients with asthma and other pulmonary diseases. Physicians may order Pulmonary Function Tests by calling the Pediatric Pulmonary Function Laboratory at (203) 688-4667. The Lab is located adjacent to the Pediatric Specialty Center in the Yale-New Haven Children's Hospital, West Pavillon, Room 260A, 20 York Street, New Haven, Connecticut. We also perform Pulmonary Function Tests at Greenwich Hospital (Map and Directions). The Pediatric Pulmonary Function Lab is directed by Pnina G. Weiss, M.D. |
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